2022-05-12T14:34:28-05:00 2021-06-30 910189318 MOSS ADAMS LLP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2020-07-01 030594291 899 CHARLESTON 899C 6504333600 899 EAST CHARLESTON ROAD PALO ALTO CA 94303 ELYSE GERSON EXECUTIVE DIRECTOR 6504333600 2022-05-09 1 ELYSE GERSON 999009999 MICHAEL LUMSDEN P01262236 4159561500 2022-05-09 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z MOLDAW RESIDENCES ELYSE GERSON 899 EAST CHARLESTON ROAD PALO ALTO CA 94303 17017896 0 X WWW.MOLDAW.ORG X 2006 CA TO PROVIDE RESIDENTIAL FACILITIES DESIGNATED TO MEET THE NEEDS OF AGED PERSONS AND ADDRESS THE WELL-BEING OF THE RESIDENTS. 8 8 151 17 0 0 110322 1194872 16206917 15604879 274775 59228 140150 158917 16732164 17017896 0 0 0 0 5494743 5626825 0 0 199037 12997891 13239925 18492634 18866750 -1760470 -1848854 145194279 143487864 189619784 189407227 -44425505 -45919363 X WE SUPPORT THE HIGHEST LEVEL OF INDEPENDENCE FOR EACH INDIVIDUAL BY PROMOTING THE PURSUIT OF A HEALTHFUL LIFESTYLE AND COMMUNITY INVOLVEMENT ON OUR MULTI-GENERATIONAL CAMPUS. WE SEEK TO PRESERVE JEWISH COMMUNITY VALUES AND TRADITIONS, WHILE SERVING THE DIVERSE CULTURES AND BACKGROUNDS OF THE ENTIRE PENINSULA REGION IN OFFERING A COMPLETELY UNIQUE RETIREMENT OPTION - "UNRETIREMENT!" 0 0 15654557 0 15604879 SEE SCHEDULE O 15654557 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 35 0 1 151 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 8 0 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 0 0 CA X BEN CHAIKA 6504333600 899 CHARLESTON ROAD PALO ALTO CA 94303 X DANIEL RUTH TRUSTEE (THROUGH 6/2021) 8.00 4.00 X 0 911285 134078 VICTOR MEINKE FORMER CHIEF FINANCIAL OFFICER 0.00 0.00 X 0 480005 56099 MICHAEL SKAFF CHIEF OPERATING OFFICER 5.00 5.00 X 0 385823 10660 SHERIE KOSHOVER FORMER CHIEF ADVANCEMENT OFFICER 0.00 2.00 X 0 300330 37801 MARY CONNICK CHIEF FINANCIAL OFFICER 6.00 4.00 X 0 277191 6278 ALEXANDER BEN-ISRAEL FORMER EXECUTIVE DIRECTOR 0.00 0.00 X 144654 0 6436 JANELL HAAG DIRECTOR OF SALES AND MARKETING 40.00 0.00 X 133669 0 10640 MICHELLE DELOS SANTOS INT ED (THROUGH 8/2020) / ASSIST ED 40.00 0.00 X 129951 0 11628 ARIELLE O HENDEL FUND DEVELOPMENT DIRECTOR 40.00 0.00 X 121004 0 13180 ALLAIN BERNABE EXECUTIVE CHEF 40.00 0.00 X 102115 0 28593 ELYSE GERSON EXECUTIVE DIRECTOR (AS OF 8/2020) 40.00 0.00 X 70712 0 2317 LARRY MARKS CO-CHAIR 1.00 1.00 X X 0 0 0 DAVID STEIRMAN CO-CHAIR 1.00 1.00 X X 0 0 0 NIEL DAVIDSON TRUSTEE/TREASURER 1.00 0.00 X X 0 0 0 MARLENE LEVENSON TRUSTEE/SECRETARY 1.00 0.00 X X 0 0 0 JEAN BLACKBURN TRUSTEE (THROUGH 6/2021) 1.00 0.00 X 0 0 0 ELLEN BROWN MD TRUSTEE 1.00 0.00 X 0 0 0 RITA GHATAK TRUSTEE 1.00 0.00 X 0 0 0 GINA ROSENFIELD TRUSTEE 1.00 0.00 X 0 0 0 NANCY ROSSEN TRUSTEE (AS OF 5/2021) 1.00 0.00 X 0 0 0 702105 2354634 317710 5 1 1 0 JEWISH SENIOR LIVING GROUP 302 SILVER AVENUE SAN FRANCISCO CA 94112 MANAGEMENT/ADMINISTRATIVE SERVICES 1132548 ALL ABOUT PARKING INC 100 S ELLSWORTH AVE 203 SAN MATEO CA 94403 PARKING SERVICES 376549 HIGHCOM SECURITY SERVICES INC 1900 WEBSTER STREET SUITE B OAKLAND CA 94612 SECURITY SERVICES 106480 AVDG LLC 41454 CHRISTY STREET FREMONT CA 94537 IT SERVICES 106115 EXIGENCY HEALTHCARE SERVICES LLC 2901 MOORPARK AVE SUITE 292 SAN JOSE CA 95128 NURSING SERVICES 105297 5 1022015 172857 1194872 RESIDENT FEES 623000 12564432 12564432 AMORT OF ENTRANCE FEES 623000 2608330 2608330 OTHER OPERATING REV 623000 432117 432117 15604879 59228 59228 REIMBURSEMENTS 900099 158917 158917 158917 17017896 15604879 0 218145 339767 339767 4086376 3500286 455752 130338 43334 30661 7702 4971 807880 650528 150479 6873 349468 305082 34862 9524 326448 326448 145554 145554 51791 51791 1641631 1459258 182373 55209 55209 240118 68589 169215 2314 611400 611400 662748 662748 324 302 22 3611269 3611269 3665256 3372035 256568 36653 428399 428399 FOOD COSTS 818285 818285 DUES & FEES 248628 227281 20737 610 EQUIPMENT RENTAL 185384 185384 DINING/KITCHEN SUPPLIES 156716 156716 390765 65603 317408 7754 18866750 15654557 3013156 199037 5646473 1343175 18052878 26341680 187811 389241 523800 4545 18843 22492 102381 468011 151930497 48768265 104785004 103162232 6938491 1606155 8938598 10150333 145194279 143487864 1400017 2295231 8714102 7199324 66104751 65166344 113400914 114746328 189619784 189407227 X -52531903 -55579098 8106398 9659735 -44425505 -45919363 145194279 143487864 X -1848854 -53060 408056 X 0 1 X 1 0 X 111575 26789 350498 110322 1194872 1794056 14546513 15920061 15763100 16206917 15604879 78041470 14658088 15946850 16113598 16317239 16799751 79835526 93870 9500 20530 71071 243762 438733 0 93870 9500 20530 71071 243762 438733 79396793 118440 145183 242764 274775 59228 840390 118440 145183 242764 274775 59228 840390 140150 158917 299067 14776528 16092033 16356362 16732164 17017896 80974983 0.98050 0.98370 0.01040 0.01040 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: REIMBURSEMENTS - 2019 AMOUNT: $ 140,150. 2020 AMOUNT: $ 158,917. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 8088314 1523780 110699 9501395 7745850 342464 8088314 7403415 342435 7745850 6994719 408696 7403415 6233945 93870 666904 6994719 0.00000 0.49618 0.50383 0 1 1 13118538 13118538 127863305 40800878 87062427 3028478 2243965 784513 7920176 5723422 2196754 103162232 BENEFICIAL INTEREST IN JHSLF 9502395 DEPOSITS HELD BY HOME OWNERS ASSOCIATION 489021 DUE FROM AFFILIATED ORGANIZATION 158917 10150333 REFUNDABLE DEPOSITS 807770 REFUNDABLE ENTRANCE FEES 108017906 LOAN PAYABLE TO JHSLF 4547371 DUE TO AFFILIATED ORGANIZATIONS 7557 FUTURE SERVICE BENEFIT OBLIGATION LIABILITY 1115724 ESTIMATED SETTLEMENT LIABILITY 250000 114746328 X 17372892 -53060 408056 354996 17017896 0 17017896 18866750 0 18866750 0 18866750 PART V, LINE 4: THE INTENDED USE OF THE ENDOWMENT FUNDS IS TO PROVIDE SUPPORT FOR RESIDENTS OF MOLDAW RESIDENCES OR ACCEPTED APPLICANTS WHO CANNOT AFFORD A PORTION OF EITHER THE ENTRY FEE OR THE CONTINUING MONTHLY COSTS, AND INCLUDES ACCUMULATED EARNINGS THEREON THAT HAVE NOT YET BEEN EXPENDED. PART X, LINE 2: U.S. GAAP REQUIRES THE ORGANIZATION TO EVALUATE TAX POSITIONS TAKEN BY THE ORGANIZATION AND RECOGNIZE A TAX LIABILITY IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE APPLICABLE TAX AUTHORITY. THE ORGANIZATION HAS REVIEWED ITS TAX POSITIONS FOR ALL OPEN TAX YEARS AND BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR THE TAX POSITIONS TAKEN. THEREFORE, NO LIABILITY HAS BEEN RECORDED. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN BENEFICIAL INTEREST IN JHSLF 1,523,780. CHANGE IN FUTURE SERVICE BENEFIT OBLIGATION -1,115,724. X X 0 1 0 0 0 0 0 0 0 DANIEL RUTH TRUSTEE (THROUGH 6/2021) 0 775564 0 0 0 135721 0 108550 0 25528 0 1045363 0 87268 VICTOR MEINKE FORMER CHIEF FINANCIAL OFFICER 0 111702 0 0 0 368303 0 52138 0 3961 0 536104 0 284783 MICHAEL SKAFF CHIEF OPERATING OFFICER 0 368441 0 50 0 17332 0 8550 0 2110 0 396483 0 0 SHERIE KOSHOVER FORMER CHIEF ADVANCEMENT OFFICER 0 218435 0 50 0 81845 0 36886 0 915 0 338131 0 63400 MARY CONNICK CHIEF FINANCIAL OFFICER 0 277141 0 50 0 0 0 5625 0 653 0 283469 0 0 ALEXANDER BEN-ISRAEL FORMER EXECUTIVE DIRECTOR 105281 0 0 0 39373 0 1950 0 4486 0 151090 0 0 0 PART I, LINE 4B DURING THE 2020 CALENDAR YEAR, A RELATED ORGANIZATION CONTRIBUTED THE FOLLOWING AMOUNTS TO THE FOLLOWING INDIVIDUALS' SUPPLEMENTAL 457(F) RETIREMENT PLAN, WHICH HAS BEEN REPORTED AS "DEFERRED COMPENSATION" ON SCHEDULE J, PART II, COLUMN (C): DANIEL RUTH - $100,000 VICTOR MEINKE - $50,000 SHERIE KOSHOVER - $30,029 ADDITIONALLY, DUE TO VESTING OF THE 457(F) RETIREMENT PLAN, THE FOLLOWING INDIVIDUALS RECOGNIZED THE FOLLOWING AMOUNTS AS TAXABLE COMPENSATION, WHICH HAS BEEN REPORTED WITHIN "OTHER REPORTABLE COMPENSATION" ON SCHEDULE J, PART II, COLUMN (B)(III) AND SCHEDULE J, PART II, COLUMN (F): DANIEL RUTH - $87,268 VICTOR MEINKE - $284,783 SHERIE KOSHOVER - $63,400 A CALIFORNIA STATEWIDE COMMUNITY DEVELOPMENT AUTHORITY 680164610 2014-11-20 81435953 REFINANCING OF EXISTING BOND AND TERM LOAN DEBT 0 0 0 A 4945000 81435953 4428299 1448074 75559580 1 0 1 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 1 0 0 0 1 A 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: CALIFORNIA STATEWIDE COMMUNITY DEVELOPMENT AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 12/06/2019 FORM 990, PART III, LINE 4A: CONSTRUCTION AND OPERATION OF 193 MAINTENANCE-FREE APARTMENTS, INCLUDING 170 UNITS FOR INDEPENDENT LIVING, 12 FOR ASSISTED LIVING, AND 11 UNITS FOR SPECIALIZED MEMORY SUPPORT, IN BUILDINGS THROUGHOUT THE PEDESTRIAN-FRIENDLY TAUBE-KORET CAMPUS FOR JEWISH LIFE, THE FIRST AND ONLY JEWISH-SPONSORED SENIOR LIVING COMMUNITY IN THE REGION SOUTH OF SAN FRANCISCO, CALIFORNIA. THE GOAL OF THIS UNIQUE NEIGHBORHOOD DESIGN IS TO FOSTER OPPORTUNITIES FOR OLDER ADULTS TO ENGAGE WITH INDIVIDUALS OF ALL AGES AS THEY PARTICIPATE IN ACTIVITIES AND ORGANIZATIONS ON THE CAMPUS. AS A CONTINUING CARE RETIREMENT COMMUNITY, 899 CHARLESTON (DBA MOLDAW RESIDENCES) ALSO PROVIDES FOR RESIDENTS' FUTURE HEALTHCARE, AS NEEDED. IN ADDITION TO HAVING ACCESS TO PERSONALIZED ASSISTED LIVING SERVICES MEMORY SUPPORT RESIDENCES ON CAMPUS, RESIDENTS ARE ALSO AFFORDED PRIORITY ACCESS TO SKILLED NURSING CARE THROUGH AN AFFILIATION WITH THE HEBREW HOME FOR AGED DISABLED. DURING THE YEAR, MOLDAW RESIDENCES PROVIDED INDEPENDENT LIVING AND MEMORY SUPPORT LIVING TO ELDERLY RESIDENTS. THERE WERE 204 RESIDENTS AT JUNE 30, 2021. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION PAID A MANAGEMENT FEE TO JEWISH SENIOR LIVING GROUP, A RELATED ORGANIZATION DURING FY2021 WHO PROVIDED MANAGEMENT, MARKETING, AND OTHER SUPPORTING SERVICES TO 899 CHARLESTON. TOTAL PAYMENTS TO JEWISH SENIOR LIVING GROUP FOR THESE MANAGEMENT, MARKETING, AND OTHER SUPPORTING SERVICES TOTALED $1,132,548 DURING THE 6/30/2021 FISCAL YEAR. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION DOES NOT HAVE "MEMBERS" BY DEFINITION OF THE BYLAWS; HOWEVER, THE FORM 990 INSTRUCTIONS ALSO DEFINE A "MEMBER" AS ANY PERSON (INCLUDING A CORPORATION OR OTHER LEGAL ENTITY) WHO HAS THE RIGHT TO PARTICIPATE IN THE ORGANIZATION'S GOVERNANCE, INCLUDING ELECTING MEMBERS OF THE GOVERNING BODY. AS SUCH, IN ACCORDANCE WITH THE FORM 990 INSTRUCTIONS, 899 CHARLESTON HAD ONE SOLE MEMBER DURING THE JUNE 30, 2021 FISCAL YEAR: JEWISH SENIOR LIVING GROUP. FORM 990, PART VI, SECTION A, LINE 7A JEWISH SENIOR LIVING GROUP, A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION, HAD THE POWER TO APPOINT A MAJORITY OF THE TRUSTEES OF 899 CHARLESTON DURING THE JUNE 30, 2021 FISCAL YEAR. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN OUTSIDE TAX PREPARATION FIRM IN CONJUNCTION WITH THE ORGANIZATION'S ACCOUNTING AND FINANCE STAFF. MANAGEMENT OF THE ORGANIZATION THEN REVIEWS THE COMPLETED FORM 990 AND FOLLOWS UP WITH THE TAX PREPARATION FIRM TO ANSWER ANY UNRESOLVED QUESTIONS. A COMPLETE COPY OF THE FORM 990 IS THEN PROVIDED TO ALL MEMBERS OF THE BOARD PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REGULARLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. EACH TRUSTEE, OFFICER, AND KEY EMPLOYEE OF THE ORGANIZATION SIGNS A CONFLICT OF INTEREST STATEMENT AND DISCLOSURE FORM. THE BOARD OF TRUSTEES REVIEWS AND DETERMINES IF ANY CONFLICTS OF INTEREST EXIST AND TAKES THE APPROPRIATE ACTION AS OUTLINED IN THE ORGANIZATION'S CONFLICT OF INTEREST POLICY, WHICH INCLUDES RECUSAL FROM ANY DECISION-MAKING PROCESS INVOLVING A CONFLICTED INDIVIDUAL. FORM 990, PART VI, SECTION B, LINE 15A DURING THE FISCAL YEAR, THE BOARD OF TRUSTEES REVIEWED AND APPROVED THE COMPENSATION PACKAGE FOR THE EXECUTIVE DIRECTOR BASED ON COMPENSATION SURVEYS AND STUDIES. FORM 990, PART VI, SECTION B, LINE 15B HAS BEEN ANSWERED "NO" (AS PROVIDED BY THE FORM 990 INSTRUCTIONS), AS THE ORGANIZATION DOES NOT COMPENSATE ANY ADDITIONAL OFFICERS OR KEY EMPLOYEES; THESE INDIVIDUALS ARE COMPENSATED BY A RELATED ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII, SECTION A, COLUMN (B): AVERAGE HOURS PER WEEK REPORTED IN FORM 990, PART VII, SECTION A, COLUMN (B) FOR DANIEL RUTH, MICHAEL SKAFF, AND MARY CONNICK APPEAR LOW AS THESE INDIVIDUALS DEVOTE A PORTION OF THEIR WORKING TIME TO AFFILIATED ORGANIZATIONS WHICH DO NOT MEET THE DEFINITION OF A RELATED ORGANIZATION, PER THE FORM 990 INSTRUCTIONS. FORM 990, PART XI, LINE 9: CHANGE IN BENEFICIAL INTEREST IN JHSLF 1,523,780. CHANGE IN FUTURE SERVICE BENEFIT OBLIGATION -1,115,724. JEWISH SENIOR LIVING GROUP 302 SILVER AVENUE SAN FRANCISCO CA 94112 800291740 SEE PART VII CA 501(C)(3) LINE 12A, I N/A 0 BAY AREA JEWISH SENIOR LIFE 302 SILVER AVENUE SAN FRANCISCO CA 94112 455092344 SEE PART VII CA 501(C)(3) LINE 12A, I JEWISH SENIOR LIVING GROUP 1 BAY AREA SENIOR HEALTH SERVICES INC 302 SILVER AVENUE SAN FRANCISCO CA 94015 454293287 MANAGEMENT CO CA N/A C 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 1 1 0 0 M PART II, COLUMN (B): JEWISH SENIOR LIVING GROUP PRIMARY ACTIVITY: TO PROMOTE THE PROVISION OF JEWISH LIVING SERVICES, FACILITIES AND AGING SERVICES IN NORTHERN CALIFORNIA BY PROVIDING SERVICES DESIGNED TO ASSIST THE SUPPORTED CHARITIES IN THEIR OWN OPERATIONS AND ASSIST WITH DEVELOPING NEW SERVICES AND FACILITIES IN THE AFFILIATED NETWORK. PART II, COLUMN (B): BAY AREA JEWISH SENIOR LIFE PRIMARY ACTIVITY: TO ASSIST THE SUPPORTED CHARITIES IN THEIR OWN OPERATIONS AND ASSIST WITH DEVELOPING NEW SERVICES AND FACILITIES IN THE AFFILIATED NETWORK.